• Surgical endoscopy · Jun 2016

    Comparative Study

    Predictors of readmission after laparoscopic gastric bypass and sleeve gastrectomy: a comparative analysis of ACS-NSQIP database.

    • Zhamak Khorgami, Amin Andalib, Ali Aminian, Matthew D Kroh, Philip R Schauer, and Stacy A Brethauer.
    • Department of Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, 9500 Euclid Ave/M61, Cleveland, OH, 44195, USA.
    • Surg Endosc. 2016 Jun 1; 30 (6): 2342-50.

    BackgroundReadmission rate is an indicator of quality in surgical practice. We aimed to determine the predictors of unplanned early readmissions following stapling bariatric surgeries.MethodsFrom the American College of Surgeons National Surgical Quality Improvement Program database, we identified morbidly obese patients, who underwent either laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) in 2012 and 2013. Demographic, comorbidities, operative and postoperative parameters of the readmitted (within 30 days) and non-readmitted patients were evaluated using a multivariate logistic regression analysis.ResultsA total of 35,655 patients (17,101 LSG and 18,554 LRYGB) were analyzed. Of those, 1758 patients (4.9 %) were readmitted within 30 days of surgery. Multivariate analysis showed the following significant predictors for readmission: Non-Hispanic black ethnicity (OR: 1.56, 95 % CI:1.34-1.81), Hispanic ethnicity (OR: 1.29, 95 % CI:1.05-1.58), totally or partially dependent functional status (OR: 1.94, 95 % CI:1.06-3.55), higher preoperative creatinine (OR: 1.13, 95 % CI:1.04-1.22), lower serum albumin (OR: 0.78, 95 % CI:0.68-0.90), diabetes mellitus on insulin (OR: 1.28, 95 % CI:1.09-1.51), steroid or immunosuppressant use for a chronic condition (OR: 1.61, 95 % CI:1.11-2.33), history of cardiac disease with intervention (OR: 2.05, 95 % CI:1.10-3.83), bleeding disorders (OR: 1.71, 95 % CI:1.15-2.54), LRYGB versus LSG (OR: 1.63, 95 % CI:1.44-1.85), longer operative time (OR: 1.13, 95 % CI:1.07-1.20), concurrent splenectomy (OR: 4.10, 95 % CI:1.05-16.01), and occurrence of any postoperative complication during index admission (OR: 2.61, 95 % CI:1.99-3.42).ConclusionsEthnicity, baseline functional status, comorbidities, type and duration of surgical procedure, and postoperative complications occurred in the index admission can predict risk of early readmission following LRYGB and LSG.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.